Summary: | Background
Article
14 of the WHO Framework Convention on Tobacco Control (FCTC) deals with demand
reduction measures concerning tobacco dependence and cessation. This
paper identifies the gaps in its implementation globally, with appropriate
recommendations to fulfill the same.
Methods
Information
regarding tobacco cessation support among the WHO-FCTC member parties was
obtained from the MPower 2017 database and from surveys like Global Adult
Tobacco Survey (GATS), the Global Health Professions Student Survey and Global School Personnel
Survey. In addition, meta-analysis of the results of the globally available
randomized trials and cohort studies on smokeless tobacco (SLT) cessation interventions was
performed, to determine the efficacy of the same.
Results
Tobacco
cessation support is available at various health care facilities in < 20%
Parties; National Quitlines in 31% Parties while Nicotine Replacement
Therapy in 70% parties (mostly in high resource and European countries). Very
few parties provide full cost coverage of the same. Health care professionals
do not equally care for SLT users and smokers. There is a lack of formal
training on tobacco cessation among health professionals, health professional students
and school personnel. Many countries have experience in smoking cessation but
only 3% Parties have experience in SLT cessation. Meta-analysis has
shown that behavioral intervention alone has 60% more chance of enabling quitting
and is the most effective way of intervention both for low and high resource
set ups.
Conclusions
Tobacco
cessation support and surveillance need to be strengthened especially in the
low resource and high SLT burden countries. Sensitization and training on
cessation to professional group is the critical issue. Effective SLT prevention
& cessation programs must be encouraged at school level itself.
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